Laparoscopic surgery is a procedure in which surgical instruments and a viewing scope, referred to generally as an endoscope and more specifically as a laparascope, are inserted through small puncture wounds or incisions into the abdominal cavity of a patient. A small video camera is attached to the laparascope and connected to a television monitor for viewing the procedure.
The instruments and the laparoscope may be inserted through cannulae, which are first inserted through the incisions. Cannulae are hollow tubes with gas valves. The cannulae are left in the puncture wounds throughout the procedure. The cannulae allow the instruments and the scope to be removed and reinserted as necessary. To aid in visualizing the intraabdominal structures, gas is inserted through one of the cannulae to raise the abdominal wall. Seals are required at the exit points of the scope and instruments to prevent the gas from escaping.
The viewing laparoscope may be inserted through a cannula, which is usually inserted through an incision made in the umbilicus. The scope is then directed towards the pelvis for pelvic surgery or towards the liver for gallbladder surgery. Throughout the procedure the surgeon, assistant surgeon, or a scrub nurse must hold the scope and direct it at the target of the surgery, which typically entails constantly repositioning the scope to obtain the best view. This process ties up one hand of the surgeon or assistant surgeon, if either holds the scope. The scrub nurses also have other tasks to perform so holding the scope interferes with performing these tasks. Additionally, the surgeon typically finds it difficult to direct others to position the scope for the best view. As a result, the scope is often misdirected when not held by the surgeon.